Fuch heterochromic cycliti: rubella viru antibodie and genome in aqueou humor

Purpoe To characterize the polypecific intraocular antibody ynthei in aqueou humor of patient with chronic inflammatory dieae of the eye and to detect the cauative antigen in Fuch heterochromic cycliti (FHC). Deign Retropective cae-control tudy. Method Intraocular antibody ynthei i detected in aqueou humor with the Antibody Index [AI] (improved Goldmann-Witmer Index) and quantified a pecific antibody fraction, F (intraocular pecific antibody concentration in percent of intraocular total immunoglobulin G in aqueou humor). Viru detection i by neted polymerae chain reaction. Reult Fifty-two eye of 52 patient with clinically defined FHC (aged 16–73 year) had an intraocular ynthei of rubella antibodie (AI ≥1.5). The rubella genome wa detected in 5 (18%) of 28 aqueou humor ample invetigated, or in 5 (56%) of 9 patient aged <40 year. Oligoclonal IgG wa yntheized in 34 (87%) of 39 eye. Unaffected fellow eye (n = 3) or cerebropinal fluid (n = 2) were normal. In FHC the median rubella AI = 20.6 (total range 1.5–309) wa even time higher than in multiple cleroi (M) patient (n = 15) with uveiti intermedia or periphlebiti retinae. In M the intraocular rubella antibody ynthei (frequency 73%) i part of a polypecific immune repone (increaed meale AI in 80%, varicella zoter viru AI in 47%, herpe implex viru AI in 23%). The median rubella-F = 2.6% in FHC (range = 0.14%–45.9%) wa approximately 40 time higher than in M, conitent with a viru-driven antibody repone in FHC. Noninflammatory control (50 enile cataract) had neither an intraocular rubella antibody ynthei (normal AI ≤1.4) nor rubella antigen in aqueou humor. The rubella AI wa normal in all patient with an intraocular toxoplamoi (n = 24), anterior uveiti (n = 27), herpe implex viru iriti (n = 25), and varicella zoter viru iriti (n = 14). Concluion Fuch heterochromic cycliti i a rubella viru-driven dieae with peritence of the viru preferentially detected in the younger patient. The propoed laboratory upported diagnoi of FHC i baed on the increaed rubella Antibody Index. The viru etiology give a rationale for omitting the ineffective corticoteroid therapy of FHC.